Whole system Traditional Chinese Medicine improving fertility and the success rate for IUI and IVF
Trevor Wing and Andrew Flower (2018) conclude in Practical problems in assisted conception Chapter 12 - "what is the role of complementary and alternative medicine during IVF? - a review of the evidence" that there is no reason to dissuade women with an interest in these supporting treatment from opting to include herbal medicines or acupuncture as part of their fertility care program.
Whole system traditional Chinese medicine (WS-TCM) include acupuncture and Chinese herbal medicine with associated interventions such as lifestyle advice, dietary recommendations, breathing and relaxation exercise and massage. WS-TCM was associated with greater odds of live birth than IVF alone and the use of WS-TCM was not associated with any increased risk of miscarriage, ectopic pregnancies or multiple pregnancies. Therefore, there does not appear to be any reason to dissuade women interested in combining IVF with WS-TCM from pursuing this path.
(A) Natural IVF cycle - ideally treatment should start three months before the IVF cycle to maximize the positive effect on folliculogenesis and then within the natural IVF cycle to improve ovarian blood supply, improve estradiol levels and improve endometrial quality, resulting in improved receptivity to embryo implantation. In the case of stimulated (short or long protocols), IVF acupuncture and or Chinese Herbal Medicine is still beneficial in the three months before the stimulated IVF cycle to improve folliculogenesis before medication begins.
(B) Conventional medicine (CM) IVF consist of several stages, with each stage modifying the patient's natural menstrual cycle. The three main elements of CM IVF treatment and CAM supporting treatment are:
1) Ovarian follicle stimulation to grow and mature as many antral follicles as possible to a size that allows each follicle to be aspirated, resulting in oocyte collection. During this phase, acupuncture and or Chinese Herbal Medicine can be used to reduce anxiety and improve blood flow within the pelvis to promote endometrial quality.
2) Follicle ripening/ovulation prevention. During this phase, there is no specific acupuncture or CHM physiology treatment indicated; however, continuing to treat to reduce anxiety, stress and adverse effects from medication is helpful.
3) Post-oocyte-collection progesterone supplementation to prevent endometrial shedding and pregnancy loss. During this phase, the contextual effects of acupuncture may help to improve embryo implantation rates. Chinese Herbal Medicine formulas that support and improve ovarian vascularity and endometrial receptivity can also be employed to help improve the chances of implantation further. Should the cycle result in pregnancy, then acupuncture and Chinese Herbal Medicine treatment can be modified to minimize miscarriage probability.
Ying Cheong (editor) et.al. (2018), Practical problems in assisted conception, Cambridge, Cambridge University Press
Infertility and Chinese Medicine
Infertility is commonly defined as an inability to conceive after 1-2 years of trying. In approximately 60% of cases the difficulty is with the woman and 40%, the man. Infertility also refers to repeated miscarriages.
In order for a woman to conceive, she must ovulate. The egg must travel through the fallopian tube towards the uterus and a man's sperm must fertilise the egg along the way. Finally the fertilised egg must implant into the wall of the uterus. Some of the main causes of infertility in women are; endometriosis (where parts of the uterine wall are deposited in the abdomen outside the uterus itself), ovulation problems, poor egg quality, polycystic ovary syndrome, and fallopian tube blockages. In men problems may be caused by low sperm count or sperm abnormalities. However, in many cases the infertility is unexplained, with no underlying problems that can be identified.
In a recent study, Chinese herbal medicine has been shown to result in a high success rate of pregnancy in infertile couples (Journal of Chinese Medicine 2006; 80; 20-8). It has shown improvements in the size and number of eggs and in the thickness of the uterine wall, all of which could help to explain its success. Chinese medicine may be used on its own or in combination with IVF or other forms of assisted reproduction.
Chinese medicine treatment is tailored to you as an individual. The practitioner will take note of your medical history, the characteristics of your menstrual cycle and your general health. This information will be used to assess the nature of the underlying imbalance, and to choose a herbal formula (a combination of herbs), which will then be modified during the course of treatment.
The aim of treatment will be, where appropriate, to regulate the cycle and support ovulation or implantation. The medicine may be prescribed as a tea or in pill form. In addition your practitioner may recommend lifestyle and dietary changes. A minimum of three months' treatment can be expected in the case of unexplained infertility. Although with underlying problems such as endometriosis treatment tends to be longer, improvement may be seen in other changes, such as a reduction in the severity of peiod pain.
"Infertility" leaflets (above information) made by the RCHM are available in the clinic. For further information, please visit Register of Chinese Herbal Medicine (RCHM)
IVF support with Acupuncture and Chinese Herbs
"With both Chinese herbs and acupuncture in preparation for and support throughout the IVF procedure, increases IVF pregnancy success rate to 60%" (Lifang Liang 2003)
Lifang Liang (2003) states that "A recent German study found that using acupuncture with IVF achieved a 42% clinical pregnancy rate in the test group, compared to 26% in the control group that did not receive acupuncture. This study involved giving acupuncture for just one day, shortly before and after the trasfer of embryos. My clinical experience is that this rate increases to at least 60% with broader support of both Chinese herbs and acupuncture in preparation for and support throughout the IVF procedure. As well, both of these modalities can significantly reduce the risk of miscarriage by supporting the female during her entire pregnancy.
A large number of patients who have tried IVF several times and were unsuccessful have soon become pregnant after Chinese medicine treatments. In clinical observation, the ultrasound shows that, after acupuncture, the color of women's ovaries change from cloudy to bright and clear. The follicles usually double in number, the lining of the uterus becomes thicker, and the number of embryos increases significantly. Patients experience less side effects from the Western drugs and feel more at ease and happy. For male patients, it is my experience that the semen quality significantly improves and the sperm number greatly increases. In brief, Chinese medicine can help to improve the success rate of IVF in a number of ways:
1. Improve the function of the ovaries to produce better quality eggs
2. Regulate the hormones to produce a larger number of follicles
3. Increase blood flow to the uterus and increase the thickness of the uterine
4. Relax the patient and decrease their stress
5. Prevent the uterus from contracting
6. Lessen the side effects of drugs used in IVF
7. Strengthen the immune system
8. Improve semen to create better quality and quantity of embryos
9. Decrease chances of miscarriage"
I am listed as one of the preferred providers of Acupuncture services of Herts & Essex Fertility Centre.
Pregnancy rate double with Chinese Medicine
Women receiving Chinese herbal medicine are twice as likely to get pregnant than those receiving Western medical fertility treatment, according to new research.
Researchers at the University of Adelaide reviewed a range of studies which in total had involved 1,851 women aged from 18 to 45 years who had received treatment for infertility. They found Chinese herbal medicine achieved on average a 60% fertility rate, compared with 30% for standard Western medical drug treatment or IVF. The reasons for infertility in the women included endometriosis, PCOS (polycystic ovary syndrome), amenorrhea and advanced maternal age. The results are published in the December issue of the journal Complementary Therapies in Medicine.
The researchers reviewed seven RCTs, one non-randomised controlled trial, 13 cohort studies, three cases series and six case studies. In these studies, women received either Chinese herbal medicine alone, Chinese herbal medicine and acupuncture, or Chinese herbal medicine in conjunction with Western drugs or surgery.
In the cases of Chinese herbal medicine being used alone the researchers concluded that pregnancy rates were significantly higher than with the sole use of Western medical fertility treatment. The same improvement in pregnancy rates was true when Chinese herbal medicine was used in conjunction with Western drugs or surgery. It was also noted in some trials that Chinese herbal medicine had fewer side effects than Western medical treatments.
Emma Farrant, chief executive officer of the Register of Chinese Herbal Medicine says, "Clinical experience has shown that Chinese medicine is very effective at treating infertility in women. While there are some weaknesses to this review overall the results are very encouraging and we hope it will lead to further well-designed and rigorous trials."
Efficacy of Traditional CHM in the Mangement of Female Infertility: A Systematic Review. K Ried, K Stuart.
Complementary Therapies in Medicine Vol 19 issue 6, 319-31, Dec. 2011
Abstract from US National Library of Medicine
Conditions treated with Acupuncture and Chinese Herbal Medicine
Conditions treated with Acupuncture and Chinese Herbal Medicine
The new Advertising Standards Association rules for media and websites no longer allow us to list which conditions we treat. Please contact me about your condition by phone on 07914 251190 and I will be happy to help.
Please refer Health Fact Sheets for general information for a variety of conditions, written by Dr Trevor Wing of the Women's Natural Health Practice (I am an associate), such as:-
Ageing and Fertility, Cystitis, Endometriosis, Fibroids, Increased IUI, IVF and ICSI success with acupuncture, menopause, natural infertility treatment, painful menstrual periods, polycystic ovary syndrome (PCOS), preparing yourself for pregnancy.
Health Fact Sheets written by Dr Trevor Wing of The Women's Natural Health Practice
(I am an associate of The Women's Natural Health Clinic)
Register of Chinese Herbal Medicine (RCHM), research
Ying Cheong (editor) et.al. (2018). Practical problems in assisted conception, Cambridge, Cambridge University Press
Lyttleton, J. (2004). Treatment of infertility with Chinese medicine. London: Churchill Livingston.
Lifang Liang (2003). Acupuncture and IVF. Boulder, USA: Blue Poppy Press